For outpatient services, please visit the outpatient clinics at any of the preferred provider hospitals listed in the Preferred Provider Booklet. Each time you seek medical care, your attending doctor will complete a claim form (ASOAP Form) containing all information regarding your medical illness, treatment and eligible costs. It is important to:
- Ensure that all fields are filled completely.
- Only sign the form after it is completed. Do not sign blank claim forms or multiple claim forms which can be used fraudulently, misusing your benefits and limits.
In order to receive your required prescription, you will be asked to present the yellow copy to the pharmacy to dispense your medication, the pink copy to the laboratories and the blue copy to the scan centers. You will also need to present your Medical ID card and personal identification.
All inpatient treatments, surgeries and same day procedures require pre-authorisation from NEXtCARE prior to their undertaking. Contact NextCare for pre-authorisation.
Pre-authorisation: Certain prescribed services require pre-authorisation from NEXtCARE prior to their delivery ensuring that they are a medical necessity, making them eligible for payment under your healthcare plan and billed according to network prices. All network providers are familiar with services that require pre-authorisation.
Pre-authorisation is required for:
- All in-patient admissions, surgeries and same day procedures
- Special investigations such as Endoscopy, CT scan and MRI
- Some diagnostic tests
- Certain pharmaceutical prescriptions